How Do You Solve a Problem like England's Cancer Drugs Fund?

October 27, 2014
Leela Barham

Leela Barham is a freelance health economist and policy expert. She has published in peer-reviewed journals and presented at national and international conferences. She has provided advice to the Department of Health and Social Care on policy on pricing of branded medicines to inform the negotiation of a successor to the UK’s Pharmaceutical Price Regulation Scheme (PPRS), the Voluntary Scheme for Branded Medicines Pricing and Access (VPAS), as well as worked with patient groups, the NHS, pharmaceutical companies and many others internationally on the economics of healthcare and pharmaceuticals. Contact Leela on leels@btinternet.com

Pharmaceutical Executive

The Cancer Drugs Fund (CDF) is a particular English approach to deal with rejections by the National Institute for Health and Care Excellence (NICE) for new cancer medicines.

The Cancer Drugs Fund (CDF) is a particular English approach to deal with rejections by the National Institute for Health and Care Excellence (NICE) for new cancer medicines.  It’s now worth £280million a year - still a drop in the ocean compared to the £5 billion or so spent on cancer by the NHS in England. 55,000 patients have benefitted from the fund according to the Department of Health.

The CDF started out with positive headlines, but over time it’s fallen out of favour with policy makers (if indeed it was ever really supported outside of the elite who advise the Prime Minister). That’s because it busted its £200 million budget in the last financial year, by over £30 million. It was also supposed to be a temporary policy, ending in 2014, it’s now planned to be in place for 6 years, running from 2010 to 2016. At the same time, NICE has said that the CDF ‘makes no sense’ and wants to take the fund over. Even the King’s Fund Chief Economist, John Appleby, has come out against the fund, suggesting that it’s inequitable and inefficient.

The answer it seems is in tougher ‘re-evaluation’ of those drugs on the approved list, including consideration of their median cost, plus encouraging companies to offer discounts if they want to keep their drugs on the list. NHS England is hoping that a combination of these will keep it within it’s £280million budget. Drugs like Avastin, Erbitux, Perjeta, Afinitor, and Abraxane could be cut according to speculation in the media. Pressure is being brought to bear on the companies to offer better prices in order to keep them on the approved list.

That’s not all; NHS England will also be working with NICE, patient groups and the Association of the British Pharmaceutical Industry (ABPI) to ensure greater ‘alignment between CDF and NICE assessment processes’.

NHS England’s consultation closes on the 31st October 2014 and we’ll have to wait and see whether that leads to the changes NHS England hope for, or if as we’ve seen with NICE for Value Based Assessment (VBA), stakeholders put the brakes on the changes.

Leela Barham is an independent health economist. You can find out more about on her website and contact her at leels@btinternet.com

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